Sound asleep

Hospi­tal mon­i­tors of­fer noise guardian for pre­ma­ture ba­bies

The Covington News - - Health & Wellness - By Tom Mur­phy

IN­DI­ANAPO­LIS — Warn­ing lights hover over the snoozing pa­tients in Ri­ley Hospi­tal for Chil­dren’s neona­tal in­ten­sive care unit, ready to flash when­ever sound lev­els creep be­yond nor­mal con­ver­sa­tion.

As deci­bels rise, the col­ors on the new mon­i­tor­ing sys­tem change from green to yel­low to red, hush­ing chatty par­ents or doc­tors so the ba­bies get the rest they need to de­velop.

Noise louder than roughly the level of con­ver­sa­tion can cause pre­ma­ture or sick ba­bies’ hearts to beat too fast or too slowly, said Dr. William En­gle, a neona­tol­o­gist at Ri­ley.

And in­ter­fer­ing with ba­bies’ vi­tal signs or sleep can slow de­vel­op­ment and heal­ing be­cause their bod­ies do most of that work while they sleep.

“ The func­tion of ba­bies is to grow and de­velop, and in be­tween they eat,” he said.

Pre­emies also need quiet so they can learn their mother’s voice and their brains can fig­ure out how to process sound, things that nor­mally hap­pen in the last trimester be­fore birth.

“ It’s def­i­nitely a great idea,” Dr. Bob White, a neona­tol­o­gist at South Bend’s Me­mo­rial Hospi­tal, said of the mon­i­tor­ing sys­tem in Ri­ley’s neona­tal in­ten­sive care unit, or NICU.

White, who is not in­volved in cre­at­ing or dis­tribut­ing the sys­tem, helped write na­tional noise stan­dards for NICUs that have been adopted by the Amer­i­can In­sti­tute of Ar­chi­tects and are used in most hospi­tal de­sign.

In­ven­tor Chris Smith hopes doc­tors around the coun­try agree with White. He has sold his Son­icu sys­tem to sev­eral In­di­ana hos­pi­tals and wants to ex­pand na­tion­ally.

Smith, 43, had no train­ing as a sound en­gi­neer and no plans to be­come an en­tre­pre­neur when his son Sean was born five weeks pre­ma­ture in 2000.

But he no­ticed Sean flinch in re­sponse to bright light in the NICU of St. Vin­cent In­di­anapo­lis Hospi­tal, and he wound up de­sign­ing a sys­tem to soften the unit’s light­ing.

Then the nurses asked him what he could do about sound.

“ That’s re­ally when I re­al­ized that there was no good way out there to mea­sure sound, other than your stan­dard, hand- held me­ter,” he said.

Ba­bies born too soon lose the muf­fling ef­fect of the womb be­fore their ears can fil­ter sound, White said.

“ The sounds ... come from all dif­fer­ent di­rec­tions and all dif­fer­ent sources, and they’re of­ten as­so­ci­ated with un­pleas­ant sen­sa­tions for the baby,” White said.

NICUs are rife with noise pol­lu­tion cre­ated by em­ploy­ees, equip­ment and ex­cited fam­ily mem­bers.

“ There’s no good way for the nurses or doc­tors to walk up to a par­ent, tap them on the shoul­der and say, ‘ You’re be­ing too loud,’” Smith said. “ That’s con­fronta­tional.”

The for­mer car me­chanic filled hours of spare time in the evenings and on week­ends re­search­ing sound stan­dards and build­ing a sys­tem.

Smith, who tin­kered in ra­dio and TV elec­tron­ics in high school, hired an acous­ti­cal en­gi­neer to help. They cre­ated a ceil­ing- mounted sys­tem of mi­cro­phones that picked up sound and fun­neled data back to a large con­trol panel.

“ There was a lot of wiring, a lot of la­bor, a lot of pro­gram­ming,” he said.

St. Vin­cent paid around $ 100,000 for the sys­tem, which it in­stalled about five years ago. Smith had no in­ter­est in shop­ping his in­ven­tion to other hos­pi­tals be­cause the work took so much time.

Then Ri­ley Hospi­tal, also in In­di­anapo­lis, called a few months later.

“ They ba­si­cally said, want that,’” he said.

The latest ver­sion of Son­icu can feed a stream of both sound and light data dig­i­tally to a com­puter. It of­fers the cone- shaped warn­ing lights and can quickly dim the light­ing in a room that gets too noisy.

It also can make light­ing mimic the sun by bright­en­ing

‘I to­ward noon and then fad­ing, which also helps ba­bies sleep well.

White, the neona­tol­o­gist who helped write the na­tional stan­dards, said he knows of no other NICU mon­i­tor­ing sys­tem that so­phis­ti­cated.

Smith has sold sys­tems to a hand­ful of In­di­ana hos­pi­tals, so far to good re­views. He said the sys­tems can cost any­where from $ 40,000 to $ 400,000, de­pend­ing on each hospi­tal’s needs.

The mon­i­tors have taught hospi­tal staff to limit the num­ber of groups mak­ing rounds at the same time be­cause hav­ing more than one group in a room raises noise lev­els dra­mat­i­cally.

Most NICUs are filled with noise that can’t be helped, White said. Fans in the heat­ing and ventilation sys­tem have to op­er­ate al­most con­stantly, and the mon­i­tors need to beep.

The Son­icu sys­tem reins in the main noise maker that can be con­trolled.

“ Peo­ple think, ‘ Oh gosh, I didn’t re­al­ize, I’ll go over here so I won’t have to talk so loud,’” White said. “ It re­ally is some­thing that ad­dresses the hu­man fac­tors that we do have some con­trol over.”

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